Causes of deferring chemotherapy administration to ambulatory pediatric patients

Abstract

Introduction: Chemotherapy has precise indications; deferring it might influence the treatment outcomes. Some causes are originated for clinical situations of patients and others for medical or administrative reasons.

Objective: To identify the main causes that deferring chemothe- rapy administration originates in pediatric patients with cancer.

Methodology: Observational and prospective study included 200 patients from 11 months to 16 years and 11 months old with hemato-onchology disorders. Causes of deferring therapy were researched throughout a check list and direct observation during 3 months. The researched variables were: not showing up to the treatment visit, medical causes, administrative reasons, and clinical causes related to patients. Statistical analysis was done with measures of central tendency.

Results: Causes of deferring chemotherapy administration were: 13.5% due to not showing up to the treatment visit with 10.5%, followed by 1.5% traumatic lumbar puncture, and 1% due to neutropenia.

Discussion: The motive of not showing up in 5.5% was not obtained. Deferring might influence the treatment outcome because the lack of administration might favor the beginning of drug resistant colonies to chemotherapy, having as a consequence losing control of the disease.

Conclusions: Some strategies should be implemented with the help of a multidisciplinary team to reach pa- tients and remind their parents their appointment, as well as let them know about the importance of com- pliance of treatment in booked da- tes.